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["附件4"]
["提供成本构成表药品清单"]
["序号","招采药品代码","药品名称","产品来源名称","剂型名称","规格名称","生产企业名称","包装","转换比","包装材质名称","最小使用单位名称","批准文号","第一省份","挂网药品1","包装价格1","规格名称1","最小制剂价格1","包装数量1","第二省份","挂网药品2","包装价格2","规格名称2","最小制剂价格2","包装数量2","第三省份","挂网药品3","包装价格3","最小制剂价格3","材料附件1","材料附件2","材料附件3","规格名称3","包装数量3","申报企业名称","最小包装挂网申报价格","日均使用费用","日均使用费用说明(说明附件材料)","最小日使用量","最大日使用量"]
[1,"ZD04AAJ0745010107199","金蓉颗粒","国产","颗粒剂","每袋装8.5g(相当于饮片42.5g)","广州市康源药业有限公司","每袋装8.5g(相当于饮片42.5g)×6袋/盒",6,"聚酯/铝/聚乙烯药品包装用复合膜","袋","国药准字Z20180002","广西壮族自治区","ZD04AAJ0745010107199",1296,"每袋装8.5g(相当于饮片42.5g)",216,6,"河北省","ZD04AAJ0745010107199",1296,"每袋装8.5g(相当于饮片42.5g)",216,6,"湖北省","ZD04AAJ0745010107199",1296,216,"https://tps.ybj.hunan.gov.cn/tps-local/XMHXgroupYPCZ/M00/AB/86/rBIBUGjnYuWAMOe0AAKrqNhsoFA022.pdf","https://tps.ybj.hunan.gov.cn/tps-local/XMHXgroupYPCZ/M00/AB/86/rBIBUGjnYxqAFuGWAAKz6e_FFoY981.pdf","https://tps.ybj.hunan.gov.cn/tps-local/XMHXgroupYPCZ/M00/AB/86/rBIBUGjnYzaAOZmNAALRWs_-RIc078.pdf","每袋装8.5g(相当于饮片42.5g)",6,"广州奇绩医药科技有限公司",1296,648,"https://tps.ybj.hunan.gov.cn/tps-local/XMHXgroupYPCZ/M00/AB/86/rBIBUGjnY5GAA5vhAA8rdku4pfE872.pdf",3,3]